Women's Health

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Less receipt of effective treatment by elderly black women with ovarian cancer may underlie their poorer survival

Most women with ovarian cancer are diagnosed with late-stage disease with poor survival rates due to lack of obvious cancer symptoms and an effective screening tool. Several studies have shown that black women are less likely to receive recommended chemotherapy in addition to surgery for advanced ovarian cancer than white, Hispanic, or Asian women, which may contribute to their poorer survival, suggests a new study.

A University of Texas team led by Xianglin L. Du, M.D., Ph.D., studied 5,131 elderly women diagnosed with ovarian cancer between 1992 and 1999 with up to 11 years of followup. Overall, 72 percent of white women and 70 percent of black women were diagnosed with advanced stage disease (stage 3 or 4). Of the 4,264 women with stage 4 disease, those who underwent ovarian surgery and received adjuvant chemotherapy were 50 percent less likely to die during the followup period than those who did not, regardless of race. Yet, fewer blacks received chemotherapy than whites (50 vs. 65 percent).

Socioeconomic status played a role in ethnic variations in receipt of these treatments. There was no significant difference in survival between black and white women with ovarian cancer after controlling for patient demographics, tumor characteristics, and treatments.

The study was supported by the Agency for Healthcare Research and Quality (HS16743). More details are in "Ethnic differences in socioeconomic status, diagnosis, treatment, and survival among older women with epithelial ovarian cancer," by Dr. Du, Charlotte C. Sun, Dr.PH, Michael R. Milam, M.D., and others, in the International Journal of Gynecological Cancer 18, pp. 660-669, 2008.